Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.
National Institute for Health and Welfare, Helsinki, Finland.
J Stud Alcohol Drugs. 2020 Mar;81(2):144-151.
Alcohol use disorders (AUDs) are associated with high social and health care costs. We compare the direct social and health care costs of patients with AUDs, according to four service use profiles: (a) AUD treatment, (b) mental health (MH) treatment, (c) AUD + MH treatment, (d) no treatment. A separate analysis of the costliest 10% is included. Furthermore, the association between the service user profile and the risk of death is examined.
Direct unit service costs were retrieved from the electronic health record system and supplemented with patient grouping-based costs for primary and secondary care services, to examine the yearly mean cost per patient in the AUD cohort (N = 5,136; 71.1% male). We used data collected in the North Karelia region of Finland between 2014 and 2018.
Total costs of care for the cohort during the 5-year follow-up were 126 million Euros, and the percentage of the costliest 10% (n = 521) was 51.7% (65 million Euros). Total costs were 12,778 Euros lower if the person received AUD treatment only, compared with those not in treatment. For those receiving MH treatment only, the total costs were 1,819 Euros higher, and costs were 1,523 Euros higher for those receiving AUD + MH treatment. Receiving any treatment was associated with a diminished risk of death (AUD: odds ratio [OR] = 0.56; MH: OR = 0.63; AUD + MH: OR = 0.41).
Receiving only AUD treatment was associated with the lowest cost of care. Our results support the early identification of AUDs and provision of treatment in specialized addiction services to lower the costs of care and improve care outcomes.
酒精使用障碍（AUD）与高昂的社会和医疗保健费用有关。我们根据四种服务使用情况，比较 AUD 患者的直接社会和医疗保健成本：（a）AUD 治疗，（b）心理健康（MH）治疗，（c）AUD+MH 治疗，（d）无治疗。包括对成本最高的 10%的单独分析。此外，还检查了服务使用者概况与死亡风险之间的关系。
从电子健康记录系统中检索直接单位服务成本，并补充基于患者分组的初级和二级保健服务成本，以检查 AUD 队列（N=5136；71.1%为男性）中每位患者的年平均成本。我们使用了 2014 年至 2018 年期间在芬兰北卡累利阿地区收集的数据。
在 5 年的随访期间，该队列的总护理费用为 1.26 亿欧元，成本最高的 10%（n=521）占 51.7%（6.5 亿欧元）。与未接受治疗的患者相比，如果仅接受 AUD 治疗，总费用将降低 12778 欧元。如果仅接受 MH 治疗，总费用将增加 1819 欧元，而接受 AUD+MH 治疗的费用将增加 1523 欧元。接受任何治疗都与降低死亡风险相关（AUD：优势比[OR]=0.56；MH：OR=0.63；AUD+MH：OR=0.41）。
仅接受 AUD 治疗与护理成本最低相关。我们的结果支持早期识别 AUD 并在专门的成瘾服务中提供治疗，以降低护理成本并改善护理结果。
